title: [Pulmonary resection in renal cell carcinoma metastasis;the influence of histologic atypia of the metastatic focus on preoperative or perioperative diagnosis].
abstract: The diagnostic potential of histological atypia grades in distinguishing between primary lung tumors and renal pulmonary metastases.
  
  
  OBJECTIVE
  In cases of pulmonary resection for renal cell carcinoma patients, both the preoperative and perioperative diagnosis of lung cancer may be complicated by the need to distinguish between a primary lung tumor and metastatic renal tumor. The degree of histological atypia (grade) of the suspected metastatic focus may indicate the source of the lesion. The aim of this study was to evaluate the preoperative and perioperative diagnostic potential of histological atypia in determining the origin of lung tumors.
  
  
  METHODS
  Five cases that involved surgery for suspected lung metastasis from renal cell carcinoma were investigated.
  
  
  RESULTS
  In cases for which the precise diagnosis of the metastatic focus was uncertain, histological atypia of the metastatic focus was of grade 3, whereas that of the primary renal cancer was of grade 1 or 2.
  
  
  CONCLUSIONS
  These findings suggest that lung metastases with grade 3 histological atypia are suspected to be primary lung tumors on the basis of preoperative imaging, and preoperative distinction between primary lung tumors and metastases from renal cell carcinoma is therefore difficult. In such cases, the choice of operative method needs to be very carefully considered.
authors.affiliation: Department of Thoracic, Endocrine Surgery and Oncology Institute of Health Bioscience, The University of Tokushima, Tokushima, Japan.
authors.forename: Mitsuteru
authors.initials: M
authors.lastname: Yoshida
authors.forename: Syoji
authors.initials: S
authors.lastname: Sakiyama
authors.forename: Kouichirou
authors.initials: K
authors.lastname: Kajiura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Toba
authors.forename: Yukikiyo
authors.initials: Y
authors.lastname: Kawakami
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Takizawa
authors.forename: Kazuya
authors.initials: K
authors.lastname: Kondou
authors.forename: Akira
authors.initials: A
authors.lastname: Tangoku
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008175:Lung Neoplasms / Q000473:pathology* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009378:Neoplasms, Multiple Primary / Q000473:pathology*; D059035:Perioperative Period; D011013:Pneumonectomy; D057234:Preoperative Period